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Aerobic exercise reduces depressive symptoms in patients with chronic heart failure

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Question: Does exercise training reduce depressive symptoms in patients with chronic heart failure compared with guideline-based usual care?

Patients: 2322 Stable patients with chronic heart failure participating in the Heart Failure—A Controlled Trail Investigating Outcomes of Exercise Training (HF-ACTION) trial who completed the Beck Depression Inventory II (BDI-II) at baseline. Possible BDI-II scores range from 0 to 63; scores of ≥14 were considered clinically significant depressive symptoms. Among participants, BDI-II scores ranged from 0 to 59 (median 8), and 28% had clinically significant depressive symptoms.

Setting: 82 Medical centres in the USA, Canada and France; April 2003 to February 2007.

Intervention: Aerobic exercise versus usual care alone. Participants randomised to aerobic exercise were provided with a treadmill or exercise bicycle and received three supervised exercise sessions per week for 3 months (90 min/week), transitioning to home-based unsupervised exercise (goal 120 min/week) for the next 9 months. Usual care participants were not given a formal exercise prescription. All participants received self-management educational materials and regular follow-up phone calls.

Outcomes: Change in depressive symptoms after 3 months exercise (primary outcome, end of the …

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